Xa kuqhutyelwa uvavanyo lwegazi, i-indices bilirubin ezintathu ziyaziwa: iqhekeza ngqo, iqhekeza elingqalileyo, i-bilirubin epheleleyo (isibalo seengqamathelo ngqo kunye ngqo). Ukwakhiwa kwe-bilirubin ngokuthe ngqo kwaye engangqaliyo kuqhutywe ngokweendlela ezahlukeneyo, ngoko ke, ukuze kuqinisekiswe ngokuchanekileyo ukuxilongwa kwi-biochemical analysis of blood controversy, kubalulekile ukuhlula ukuba yiyiphi i-bilirubin yonyuka-ngqo okanye engacacanga. Cinga ngento ehambelanayo (eboshwe, edibeneyo) ye-bilirubin, yiyiphi imilinganiselo eqhelekileyo yale nqondiso, kwaye kuthetha ukuthini ukuba i-bilirubin ngqo kwigazi iphakanyisiwe.
Ukubunjwa kwe-bilirubin ngqo kumzimba
Le ngxube ye-bilirubin pigment iyinxalenye yeekhemikhali eyenziwa kwi-hepatocytes (iintsholongwane zesibindi), emva koko iindawo ezininzi zihlangana kunye ne-bile emathumbu. Kulapho, ikwahlukana kwaye ikhutshwe emzimbeni, ikakhulukazi ngamanzi kunye nexabiso elincinci - ngeentso. Inxalenye encinci ye-bilirubin ngqo ivela kwiiseli zesibindi ukuya kwigazi.
I-bilirubin ngokuthe ngqo ayinobuthi (xa kuthelekiswa ne-bilirubin engacacileyo), le ngxube inomsocoko wamanzi. Igama elithi "ngqo" i-bilirubin livela kwinto yokuba le nkunkuma inika impendulo ngokuthe ngqo kwi-diazo reagent (isisombululo esinomsoco we diazophenylsulfonic acid) esetyenziswe ekuhlalutyweni kwezinto eziphilayo.
Isiqhelo kunye nexabiso lokuxilonga kwe-bilirubin ngqo
Isalathisi se-bilirubin echanekileyo yegazi ngummakishi onobubele wesifo sebindi. Isiqhelo sabantu abadala sikwi-0.86 ukuya ku-5.3 μmol / l, malunga nekota yexabiso le-bilirubin egazini. Kubalulekile ukuba uqaphele ukuba umlinganiselo ophezulu wendlela eqhelekileyo ixhomekeke kwiimpawu ezisetyenziselwa ukucacisa le ngcaciso, kodwa impazamo ayidluli kwi-10-15%.
Ngokwayo, i-bilirubin ayiyiyo ingozi ekhethekileyo kwimpilo yabantu, i-tk. udibaniswe kwaye, ngenxa yoko, ayinobungozi kwaye kufuneka ashiye igazi. Kodwa kubalulekile ukuba akukho mingcipheko kumendo wayo, kwaye uxhumano olujoliswe ekuhoxisweni alubuyiswa.
Ingxininiso ekwandisiweyo yeqhekeza ye-bilirubin ngokuthe ngqo (i-conjugation hyperbilirubinemia) ibonakalisa iinkqubo ze-pathological processes. Kule meko, i-bilirubin ngqo iqokelela kwiisisu zomzimba zomzimba, i-eyeballs, isikhumba. Ukliniki kwizigulane, oku kungabonakaliswa yimpawu ezifana nokumnyama komchamo, intlungu kwi-hypochondrium enyanisekileyo, ukunqabisa isikhumba, i-jaundice.
Yintoni echaphazelekayo ye-bilirubin ithetha ntoni?
Ukuba i-bilirubin echanekileyo egazini yanda, izizathu zezi zinto zinxulumene neendlela ezahlukeneyo zezifo, oku:
- kunye nokunyuka kwe- hemolysis (intshabalalo) yeeseli zegazi ze-erythrocytes, ezibangela ukuba i-bilirubin engaphezulu;
- kunye nokuphulwa kokuguqulwa kwamanzi nge-bilirubin kwi-hepatocytes;
- kunye nokuphulwa kwemishini ye-excretion ye-bilirubin evela emzimbeni.
Izifo ezinokuthiwa zizizathu zokunyuselwa kokuqukethwe kwe-bilirubin ngqo kwigazi zibandakanya:
- umonakalo wesibindi (oquka i-viral kunye ne-bacterial hepatitis);
- hepatitis;
- i-hepatitis (kubandakanye nalawo ahlanganiswe nezilonda ezizimele zezinye izitho);
- cholestasis intrahepatic;
- i-cirrhosis yebhiliyari ;
- izidumbu ze-pancreatic;
- cholelithiasis;
- izilonda ze helminthic;
- izibilini zesibindi (kuquka nomhlaza);
- i-metastases kwisibindi;
- I-Dabin-Johnson syndrome;
- I-Rotor syndrome;
- sclerosing cholangitis;
- i-jaundice yabasetyhini abakhulelweyo, njl